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Last Updated: Tuesday, 26 August, 2003, 10:19 GMT 11:19 UK
IVF increase: Can the NHS cope?
An embryo created for IVF treatment
An independent watchdog has recommended that IVF is freely available on the NHS.

However, there are fears that this may mean that couples could face long waits before they receive treatment.

The UK has long been the poor man of Europe when it comes to IVF - the bulk of all treatments are carried out privately.

Some patients can get treatment on the NHS, while their neighbours in another area might be turned down flat.

However, it looks increasingly likely that this is going to change.

The National Institute for Clinical Excellence (Nice), a body charged with advising the government about the cost-effectiveness of medicines and treatments is preparing a report about fertility treatments.

Early signs are hopeful for the thousands of couples who cannot conceive, but who cannot afford private treatment.

It's not unthinkable that women could go on the waiting list within the age limit, and be past it before they received treatment
Dr Sue Avery, Association of Clinical Embryologists
Nice recommends that couples should be eligible for up to three "fresh cycles" of IVF on the NHS.

A cycle is a month-long course of treatment which usually ends in the implantation of one or more embryos.

Couples would also be able to freeze "surplus" embryos left over from a cycle and try for a pregnancy using these.

Good result

Even though there are age restrictions, this is widely regarded as a remarkably generous result for NHS patients.

However, this will not necessarily come to pass.

This level of treatment could add up to a bill of many thousands of pounds per couple - a price that the NHS may find hard to stomach.

There remains a considerable rump of public opinion that is fundamentally opposed to NHS funds being spent on any kind of fertility treatment.

There is still the chance that ministers, faced with the prospect of many millions diverted from the rest of the health service, will use their powers to offer fewer cycles, or perhaps throw out the Nice recommendations altogether.

The public will not know until February, when the formal recommendation is made, what the government intends to offer.

While the money is a major issue for the NHS, there are other concerns.

Announcing the arrival of free NHS fertility treatment will create an instant tidal wave of couples heading for their GPs to get themselves on waiting lists.

There is the possibility that those lists could be extremely long.

In countries, such as those in Scandinavia, which offer far easier access to subsidised or free IVF, the number of cycles carried out per 1,000 population annually dwarfs the total carried out in the UK.

There are considerable fears that there is simply not the capacity here to cope - and that no quick solutions exist.

More capacity needed

Dr Sue Avery, who chairs the Association of Clinical Embryologists, told BBC News Online: "Obviously, there would have to be a great deal of use of the private sector.

"But we would also need a great deal more investment to expand capacity.

"It's not unthinkable that women could go on the waiting list within the age limit, and be past it before they received treatment."

She said: "The problem is that it takes time to train staff such as embryologists."

Dr Francoise Shenfield, who chairs the Ethics committee of the European Society for Human Reproduction and Embryology, told BBC News Online: "There are certainly questions over whether there is the manpower to cope."

The problem is that the clock is ticking for many of the women waiting for IVF.

Once a woman reaches her late 30s, the chances of success starts to fall rapidly.

The proposed guidelines would limit treatment to women under 40.

If waiting lists are too long, will women get the chance to complete their cycles in time?

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